Repricing Firm Isn’t Fiduciary, Agent In Out-Of-Network Care Reimbursement Case

Mealey's (December 12, 2022, 4:01 PM EST) -- LOS ANGELES — Repricing claims and submitting the suggested rates to an insurer constitutes ministerial tasks and does not confer fiduciary status under the Employee Retirement Income Security Act or establish that the entity repricing claims is an insurer’s agent, a federal judge in California said in granting summary judgment to a repricing firm in an out-of-network substance abuse care reimbursement case....